The prevalence of malnutrition is high in elderly people in hospital, living in
nursing homes, or involved in home care programs. Development of malnutrition
in the elderly is usually a continuum, starting with inadequate food intakes, followed
by changes in body composition and biochemical variables.
In 1997, Nestle created the Nutrition Strategic Business Division (NSBD) in
order to centralise and enhance its specific competence in nutrition. Thus, five
departments compose this division. Infant and Child Nutrition covers normal
and disease-related nutrition for this age group.
The Mini Nutritional Assessment (MNA), which is composed of simple measurements
and brief questions that can be completed in about 10 min, was designed
and validated to provide a rapid assessment of the nutritional status of frail
elderly people in order to facilitate nutrition intervention [1, 2].
The normal physiological consequences of aging alter body size and composition.
These alterations affect or are affected by weight-related health conditions
and nutritional status.
An altered (impaired) immune response has previously been detected in elderly
individuals [1, 2]. Several investigators have suggested that this impaired
immune function is caused by a basic defect in receptor signalling of immune cells
and an altered capacity to respond to antigen-dependent activation signals .
Malnutrition in geriatric hospital inpatients over 75 years old is one of the strongest
indicators of a poor outcome, including mortality. A subjective rating of the
nutritional status correlated strongly (p ! 0.001) with the subsequent mortality at
follow-up times of 6, 18, and 30 months after discharge from hospital.
Many studies show that odor perception declines with age, while diminished
odor perception is associated with poor general health and various diseases [1–3].
Though it has been suggested that many nutrients play a role in odor perception,
One of the main objectives of gerontological medicine is to assist people reaching
retirement age to age successfully. As defined by Rowe & Khan [1, 2], successful
aging encompasses three distinct domains: avoidance of disease and disability;
maintenance of high physical and cognitive function, and sustained engagement
in social and productive activities.
It is now well established that there is a linear decrease in food intake of
humans over the life span . This occurs in the face of an increase in weight and
body fat in middle age.
Nutritional integrity is clearly essential for health in older persons , and the
Mini Nutritional Assessment (MNA) instrument has been shown to be an effective
measure of risk of nutritional failure in older individuals .
Weight loss, behavioral problems, and food disorders are common in patients
with Alzheimer disease. Recently, White et al.  found that weight loss was
present in 36% of Alzheimer disease patients compared with 18% in controls.
Malignant diseases are among the leading causes of premature death in Western
countries, and this is also becoming a tragic reality in other parts of the world
Comprehensive geriatric assessment (CGA) is a multidimensional interdisciplinary
diagnostic process intended to determine a frail elderly person’s functional
capabilities and medical and psychosocial problems, in order to develop an
overall plan for treatment and long-term follow-up.
Aging and malnutrition are both well-known surgical risk factors. With regard
to age, several clinical studies have shown increased postoperative morbidity and
mortality in patients over 60 or 65 years [1–4].
The prevalence of protein-energy malnutrition (PEM) is very high among the
elderly hospital inpatient population and among elderly people living in nursing
Poor nutritional status in the elderly population is now well documented. Malnutrition
affects around 20–75% of elderly patients in the hospital , 10–60% in
nursing homes [2, 3] and 1–9% at home .
When we started working on nutrition and aging in Toulouse, we worked first
on nutritional markers. Our problem was that there were too many nutritional
markers: anthropometry; biological markers, bioelectric impedance, DEXA, and
so on. We had the same kind of problem with dementia and Alzheimer disease.
There is no unique marker for Alzheimer disease, so we needed a reliable means
of neuropsychological assessment.
Protein-energy malnutrition in elderly people living at home is observed in
5–8% of the population, whereas in subjects staying in hospitals or in other institutions,
the rate varies between 30% and 60% [1–10].
The aging represent the single most rapidly increasing segment of the population
of Westernized countries and throughout much of the world [1, 2]. In the
USA, obesity is the major nutritionally related health complication of adults and
older Americans, where it has been variously reported to affect up to one in three
or more of that population [3–5].
Our aim in this study was to evaluate the MNA in a population of institutionalized
elderly people, and its correlation with functional and nutritional variables.
Dr. Vellas: Is it a physician or a nurse who does the MNA in the nursing home?
Dr. Cappa: The physician does it.
Dr. Chumlea: You had 24 men. There can be sometime a sex and age interaction, particularly
in men. Were the men more severely affected or was there no sex difference in the